What are good /bad codes for insurance?

[Guest guest]

First of all, thank you so so much to all of you - I learn so much

and get so much support from reading your posts.

Has anyone had any experience (good or bad) getting coverage for

speech therapy through an Empire Blue Cross Blue Shield PPO (my

employer is in NY if that makes any difference)? I understand that

the plans are not uniform across different employers, but thought it

would be helpful to find out what codes worked and did not work,

since mine will cover 100 sessions per year @ 80% if she qualifies

under their guidelines (translated: they get the right codes,

definitely not developmental). Even if you did not have the same

insurance, if you have good information to share on codes, that

would be really great.

My 2-year old daughter (apraxia (diagnosis was dyspraxia but I was

told it's the same thing), with mild central hypotonia) has been to

two different speech therapists (not simultaneously) and they put

totally different codes on their invoices but both are willing to

work with me and change them if I provide codes that I believe will

work with insurance (obviously provided they agree that the codes

are valid in her case). The suggested codes are as follows: From

the first therapist: 728.9 and 784.69. From the second therapist:

315.40 (I thought 300's are a no-no because they are

developmental???), 781.31 (hypotonia) and 524.50.

Any input would be greatly appreciated as I really want to have my

best shot at paying my credit card bill back down!